Kenmetal, LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

Legal business name

KENMETAL, LLC

Doing business as

Kenwood Manor

Practice address

502 W Pine Ave
Enid, OK 73701-3032

Phone

(580) 233-2722

Fax

(580) 234-1503

NPI assigned

Feb 18, 2011

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Chris Brogdon

Title

Manager

Phone

(770) 650-8793

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Kenwood Manor Doing business as

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1297987200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1642550400000",
    "number": "1811294333",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "502 W PINE AVE",
            "city": "ENID",
            "state": "OK",
            "postal_code": "737013032",
            "telephone_number": "580-233-2722",
            "fax_number": "580-234-1503"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "502 W PINE AVE",
            "city": "ENID",
            "state": "OK",
            "postal_code": "737013032",
            "telephone_number": "580-233-2722",
            "fax_number": "580-234-1503"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KENMETAL, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-02-18",
        "last_updated": "2022-01-19",
        "certification_date": "2022-01-19",
        "status": "A",
        "authorized_official_last_name": "BROGDON",
        "authorized_official_first_name": "CHRIS",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "770-650-8793"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200059530A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Kenwood Manor",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Kenwood Manor",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Tiffany A Keitz, S.L.P.
• David Edward Keller, M.D.
• Lauren Keller
• Austin Kelly
• Dena Ernestine Kemp, MSW, CADC, CPS, BHRS
• Jill Kennedy, MCP, LPC
• John W Kennedy, RPH
• Lillie Kenner
• Kenneth L Watts MD PC
• Sarah Kent, LPN

• Skilled Nursing Facility in Enid, OK
• Providers in Enid, OK by specialty
• Skilled Nursing Facility in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.